One in three people in the U.S. have metabolic syndrome, a group of health conditions that together increase the risk of coronary heart disease. The good news is that metabolic syndrome is largely preventable and reversible. Preventing or reversing metabolic syndrome starts with knowing what you can do and the symptoms to look for. If you don't know the symptoms, you could have metabolic syndrome and not even know it.
Keep reading for everything you need to know about metabolic syndrome, including the one sign of it that many people miss, according to cardiologists.
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How Metabolic Syndrome Impacts Cardiovascular Health
"Metabolic syndrome is a cluster of conditions that increase the risk of heart disease, diabetes and stroke, including high blood pressure, elevated blood glucose, low HDL ('good') cholesterol, elevated triglycerides and large waist circumference," says cardiologist Dr. Nieca Goldberg, MD. She explains that each of these conditions is a risk factor for cardiovascular disease. "When a person is diagnosed with metabolic syndrome -- having three or more of these conditions -- the risk of cardiovascular disease increases by twofold," she says.
Dr. David Davidson, MD, a cardiologist at Endeavor Health NorthShore Hospitals, says that the medical conditions that metabolic syndrome consists of are intertwined; they share the same causes, which is why many people develop more than one. He explains that having just one of the conditions puts someone at a higher risk for heart disease, and having more than one increases the risk even more. This is because each condition puts stress on the cardiovascular system, making it work harder.
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"People with metabolic syndrome tend to have underlying systemic inflammation. Inflammation leads to plaque vulnerability. Plaque vulnerability leads to plaque rupture and defense," Dr. Davidson says.
The Unexpected Sign of Metabolic Syndrome Many Miss
Hopefully, you are seeing your primary care doctor at least once a year for an annual check-up. Dr. Davidson says that blood pressure is typically measured at these check-ups, so it's important not to miss them. This is how you can know whether or not your blood pressure is too high, one of the health conditions that can be part of a metabolic syndrome diagnosis. During these appointments, your doctor can also check your LDL cholesterol and HDL cholesterol so you know whether or not they are in a healthy range.
Dr. Goldberg says that many people don't realize the connection between waist circumference and metabolic syndrome. A waist circumference greater than 35 inches for women and 40 inches for men is considered elevated. "It is often overlooked since many people do not have a habit of measuring their waist circumference at home. It's important to monitor these numbers so you can take action should there be any signs," she says.
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Connected to this, cardiologist Dr. Tracy Paeschke, MD, FACC, says that having an apple-shaped figure is a sign of metabolic syndrome to be aware of. "Excess weight is a major cause of metabolic syndrome and it sets into motion a cascade of events that leads to increased risk of heart disease," she says.
Dr. Paeschke explains that stored fat cells release chemicals that affect how the body controls blood sugar levels. "This can cause insulin resistance where the body does not respond to insulin which is secreted by the pancreas. As a result, the cells in the body don't take up glucose from the blood like they should. This insulin resistance is a precursor to diabetes. Insulin can also raise LDL cholesterol, lower HDL cholesterol and raise triglycerides," Dr. Paeschke says.
In addition to all this, Dr. Paeschke says that fat cells release chemicals that cause inflammation, which can eventually cause plaque in the arteries to become unstable and rupture, causing a stroke or heart attack. With all this in mind, it becomes clear how waist circumference is connected to metabolic syndrome.
If your weight circumference is one that's considered elevated, you may be discouraged to learn how it can negatively impact your heart. The good news is that it's reversible. Yes, reducing your waist circumference isn't easy, but it can be done by changing your diet and lifestyle and taking prescription medication if needed. If you are having trouble maintaining a healthy weight through diet and lifestyle habits alone, talk to your doctor to see if a prescription medication is right for you.
Avoiding metabolic syndrome -- or reversing it if you do have it -- is an important way to protect your heart and could literally save your life. If you have any questions about it, talk to your healthcare provider. It might be the most important conversation you ever have!
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SourcesDr. David Davidson, MD, a cardiologist at Endeavor Health NorthShore HospitalsDr. Nieca Goldberg, MD, cardiologist at NYU Langone Health and Clinical Associate Professor of Medicine at NYU Grossman School of MedicineDr. Tracy Paeschke, MD, FACC, a double board-certified cardiologist with over 25 years of experience